Provider Demographics
NPI:1518019710
Name:GRIFFIN, PAULA JANE (LMHC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:JANE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:JANE
Other - Last Name:FOOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 HENDRICKS AVENUE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207
Mailing Address - Country:US
Mailing Address - Phone:904-396-2666
Mailing Address - Fax:904-396-2698
Practice Address - Street 1:3601 HENDRICKS AVENUE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-396-2666
Practice Address - Fax:904-396-2698
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ117EOtherBLUE CROSS BLUE SHIELD
FLZ9912OtherBLUE CROSS BLUE SHIELD
9439247OtherPRIVATE HEALTHCARE SYSTEM